의과대학 임상실습 학생과 환자 및 보호자의 의사소통에 대한 질적 연구

Abstract

This study explored communications between patients (and/or their guardians) and medical students during clinical clerkships or rotation training, which refers to the practice of medicine during medical students’ third or fourth years of study. The study first identified existing problems in their communication to seek resolutions to better communication by analyzing both students’ reports collected over three years and narrative interview data of experiences of patients (and/or their guardians) while communicating with clerkship students. As a result of analyzing the data, this study revealed that patients and their guardians found communication with clerkship students uninformed, unprofessional, halfhearted, and meaningless. They also complained that some clerkship students attempted conversation with patients and their guardians at inappropriate and inconvenient times, like during the early dawn. Most clerkship students experienced negative reactions from patients and their guardians while communicating with them; these reactions included ignorance, refusal, noncooperation, insincerity, discomfort, annoyance, or anger. Such negative responses to these students tremendously affected them and caused them to negatively criticize themselves while becoming frustrated and atrophied, leading the students to passively engage in training. To improve communication between the student trainees and patients and their guardians, this study proposed the following four suggestions. First, clerkship directors or advisors should find steps to appropriately introduce clerkship students to patients and/or their guardians before a clinical clerkship begins. Second, clerkship directors and teaching hospital personnel must inform patients and their guardians of the role of teaching hospitals as clinical training centers to seek cooperation and understanding regarding medical clerkships. Third, standardized guidelines or manuals (e.g. what, when, and how to communicate with patients) for better and more effective communication with patients and their guardians should be provided to students before they begin clinical clerkship training. Finally, a systematic medical communication curriculum should be implemented for students so that they are trained on basic communication skills such as listening, empathy, consideration, and respect for patients.